President Vice President Secretary Treasurer

President
Vice President
Secretary
Kiran Ghodasara
Manu Dadhania
Sanjay Jagani
Treasurer
Prakash Govani
(732) 761-9829
(856) 751-8117
(609) 897-0250
(215) 343-8586
September 25th 2013
Dear Members,
Patidar Cultural Association committee is happy to announce this year’s annual Diwali
Celebration Saturday, November 9th 2013. Please make a note of these dates & places. Find
more details on our website http://www.pcaofusa.org
DIWALI CELEBRATION:
Place: Royal Albert’s Palace, 1050 King Georges Post Road, Fords, NJ 08863
Phone: 732-661-1070 & 732-661-1071
Visit http://www.royalalbertspalace.com
Date: Saturday, November 9th 2013
Time: 5:00 pm to 11:30pm
Donations: Adult Members - $20, Children below 18 years of age - $1, (Use registration form
attached).
HIGHLIGHTS
* DESSERT COMPETITION *
* AARTI THAALI COMPETITION *
* HINDI KARAOKE SINGING PERFORMANCE *
* RAFFLE – 5 EXCITING PRIZES, FIRST 3 FROM PREMJI VALJI *
* GAME SHOW *
PCA would like to continue to recognize our fresh College Graduates. If you or your child
graduated between September 2012 and August 2013, provide the information with Diwali
Registration Form.
You are welcome to Sponsor any Events or part of an event in our programs, for example Food,
Hall Rent, Cultural programs, Competitions, Trophies, & Raffle Prizes to cover the cost of the
Diwali celebration. All Donors will be recognized at the event for their generosity.
Please contact Kiran Ghodasara at (732) 761-9828, Manu Dadhania (856) 751-8117, Prakash
Govani at (215) 343-8586 or Sanjay Jagani (609) 897-0250 for donations.
Attached you will find:
1. Directions to Royal Albert’s Palace, 1050 King Georges Post Road, Fords, NJ 08863
2. Diwali Registration Form.
3. Cultural Program information and Registration Form
4. & 5. Student Excellence Award Information and Award Entry Form.
6. Registration for Lifetime membership.
7. Charitable Donation Form
Sincerely,
PCA Committee
Please visit us at http://www.pcaofusa.org for e-mail signup & other information.
President
Vice President
Secretary
Kiran Ghodasara
Manu Dadhania
Sanjay Jagani
Treasurer
Prakash Govani
(732) 761-9829
(856) 751-8117
(609) 897-0250
(215) 343-8586
Royal Albert’s Palace
Maharaja Hall
1050 King Georges Post Road
Fords, NJ 08863
732-661-1070
http://www.royalalbertspalace.com
Saturday, November 9th 2013
A. From NJ Turnpike North or South: Take Turnpike to Exit 10. Bear to your right. Take Route 514
(West). Follow direction (H) below.
B. From Garden State Parkway (Going) South: Take Exit 129 and stay in the right lane. Follow Signs to
Route 287. Follow direction (F) below.
C. From Garden State Parkway (Going) North: Pass Exit 123. Stay right for 4 miles to exit for Route
287. Take Route 287 exit. Follow direction (F) below.
D. From Route 1 (going) North: Pass PC Richards (Edison): Take Exit for Route 440 (Home Depot).
Take 2nd Exit (500 feet after Turnpike Exit) for Route 514 (West). Follow direction (H)
below.
E. From Route 1 and 9 (going) south: Pass Menlo Park Mall. Go 1.5 miles. Take exit for Bonham Town.
At 1st traffic light turn left onto Route 514 East (Woodbridge Avenue). Drive 1 mile and take Raritan
Center Exit. Go to the Stop Sign. Make left turn. Pass Ramada Inn, follow King Georges Post Road for
1.5 miles. Royal Albert's Palace is on the right hand side.
F. From Staten Island / Outer Bridge X-ring (Route 440): Route 440 changes to Route 287 in NJ. On
Route 287, stay in the 2nd right lane for Turnpike and Route 514. Take exit for 514 west. From left lane,
follow direction (H) below.
G. From Route 287 (going) south: Pass Exit 1. Take Route 514 West. Exit (500 feet after Turnpike).
Follow direction (H) below.
H. From Route 514 (Woodbridge Avenue) (West): Drive 1/2 mile on Route 514 West. Take 1st exit for
Raritan Center. At 1st Traffic light make left onto King Georges Post Road. Pass Ramada Inn. Drive 1.5
miles. Royal Albert Palace is on the right hand side.
Please visit us at http://www.pcaofusa.org for e-mail signup & other information.
President
Vice President
Secretary
Kiran Ghodasara
Manu Dadhania
Sanjay Jagani
Treasurer
Prakash Govani
(732) 761-9829
(856) 751-8117
(609) 897-0250
(215) 343-8586
DIWALI REGISTRATION FORM
Last Name __________________ First Name ____________________ Middle _____________
Street Address _______________________________________________ Apt # ____________
City _________________________________ State ________ Zip Code ___________________
Home Phone # (______) ______-________
Cell / Work Phone # (______) ______-________
E-Mail _______________________________________________________________________
Members
Number #
Adult Members
Children below 18 yrs
PCA Community Hall
Total
Donation
Total Amount
X $ 20
$
X $1
$
$
$
*** You can also register & pay on our website http://www.pcaofusa.org through Paypal***
(If you or your relative is interested in attending the event & financially cannot afford the donation then contact one of our
Committee Member personally)
***Early Registration Opens 2 weeks before for Lifetime Members only ! ***
Last Day of Registration is October 31st 2013
Please Make your Check payable to ‘PCA of USA’
Mail this form along with your exact Payment to :
PRAKASH GOVANI
2030 BALLANTINE LANE
WARRINGTON, PA 18976-2737
Note :
Registration fee will be fully refunded if cancellation is mailed or emailed by November 1st 2013.
Registration at the gate is Strictly discouraged.
Registration is limited & will be first come first serve.
Alcoholic Beverages are Strictly Prohibited.
Please visit us at http://www.pcaofusa.org for e-mail signup & other information.
President
Vice President
Secretary
Kiran Ghodasara
Manu Dadhania
Sanjay Jagani
Treasurer
Prakash Govani
(732) 761-9829
(856) 751-8117
(609) 897-0250
(215) 343-8586
DIWALI CULTURAL PROGRAM 2013
If you or your Child would like to participate in the Annual Diwali Cultural Program, please fill out the
form & should be Received by mail or email no later than November 1st 2013 at the address below.
Mrs. RAJESHREE GOVANI
2030 Ballantine Lane, Warrington PA 18976-2737
(215) 343-8586, Please call before 9PM
Email: rajeshreegovani@yahoo.com
* DESSERT COMPETITION *
* AARTI THAALI COMPETITION *
* HINDI KARAOKE SINGING PERFORMANCE *
* RAFFLE – 5 EXCITING PRIZES, FIRST 3 FROM PREMJI VALJI *
* GAME SHOW *
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Items will be accepted on a first come, first serve basis.
NO items will be accepted by Telephone!
One solo per family.
Group items are strongly recommended.
Children under 12 cannot perform a solo
4 announcers for MC’s of the event will be accepted
Dessert & Aarti Competitors Register at Registration desk on same day
Submit Music/Song CD to Mrs. Rajeshree on same day or mail by Nov 1st 2013
Karaoke Performers can bring their own Karaoke CD on the same day or Email
us the Song in advance by November 1st 2013
Item name (e.g. Dance, Recital, Aarti, Karaoke) ____________________Length ( Limit 5 minutes) ______
Description of item (details about the song): ________________________________________________
Contact Last Name _________________________ First Name ___________________________
Contact Phone: (______) ______-________ Contact email: ______________________________
PARTICIPANTS
LAST NAME
FIRST NAME
AGE
1
2
3
4
5
Note: PCA Entertainment Committee reserves the right to screen items & make last minute
changes if necessary. To add more participants on the list use an extra page.
Please visit us at http://www.pcaofusa.org for e-mail signup & other information.
Shri Ambavibhai & Shrimati Otamben Bhalodia
Memorial
Student Excellence Award
This Student Excellence Award is annually sponsored by Dr. & Mrs. Mohan & Rasila Bhalodia in
memory of Late Sri & Srimati Ambavibhai and Ottamben Bhalodia. The Aim of the award is to
inspire and promote excellence in our youth as they grow up to be among the most valued citizens of
USA, bringing unique talent and noble character in their life pursuits, and strengthening the positive
image of our community.
Three awards, one each of $500, $300, and $200 US Savings Bond will be presented with a
certificate of excellence to top three students selected based on the following eligibility criteria and
selection process.
Eligibility & Minimum Requirement : To enter for the award, a student must meet ALL of the
following requirements:
1. Must be a member of KPS/PCA or a child of a member of KPS/PCA.
2. High school senior or graduate entering college during the award year.
3. SAT (New) Math, Critical Reading and Writing combined score of 2100
4. Two or more SAT Subject Tests (SAT II) with minimum score of 680 in each
5. Three or more AP tests (any subject) with an average of 4
6. Minimum GPA equivalent to 3.5 on a scale of 4.0
7. Active participation in at least two extracurricular activities for a minimum of one year in each.
Entry process is made very simple for eligible students. All the information necessary to evaluate
candidates on a consistent basis is gathered in one-page entry form under Honor system. No essay,
supporting information or document is required. The entry form may be obtained from the sponsor or
downloaded from PCA web site. Entries must be received by the deadline shown on the entry form.
Selection of Award Recipient : To make the selection process unbiased and as objective as possible, a
"Student Excellence Index (SEI)" has been developed. SEI will be calculated for each qualified
candidate entering for the award. Students with top three SEI will receive the awards. If top two of
them have the same SEI, they will share first two awards equally. Similarly, if second and third have
same SEI, they will share second and third award equally.
SEI takes into consideration a student's performance on the SAT, SAT Subject Tests, AP Exams, GPA,
extracurricular activities, and other awards/honors/recognitions. These performance attributes are
weighed in the SEI formula such that no single attribute can overshadow the others. It provides a
consistent basis for candidate evaluation in line with the spirit and theme of Student Excellence.
Announcement & Presentation of Award : Award winners will be notified within four weeks after
the entry deadline, and may be asked to provide necessary documents to verify their entry information.
Winners will be announced at the annual Diwali function where the awards will be presented by the
sponsor. Winner and immediate family member(s) must be present in person to receive the award.
Sponsor Reserves All Rights : The sponsor intends to continue to sponsor the award each year. They,
however, reserve the right to discontinue the sponsorship and the award at any time by notifying PCA.
Also, sponsor reserves all rights to amend or alter selection process including selection criteria and
minimum requirements. Any such changes will be applied uniformly to all candidates in subsequent
award years, but shall not affect past awards. Sponsor's decision regarding award winner shall be final.
Rev. 10/2012
Shri Ambavibhai & Shrimati Otamben Bhalodia
Memorial
Student Excellence Award Entry Form
Student Name
SS No :
Address
City, State, Zip
Area code :
Phone
Number:
e-mail :
High School
Graduated (Month/Year) :
College Admitted
Starting (Month/Year) :
SAT Combined Score
(Out of 2400)
If SAT is taken more than once, enter
the highest total score from any single
sitting. Do not add highest Verbal
from one sitting with highest Math
from another.
GPA
Out of
Extra Curricular Activity
SAT Subject
(Enter up to 3 Subject)
AP Exam
Score
1.
2.
3.
(Enter up to 5 Subjects)
Score
1.
2.
3.
4.
5.
For SAT II and AP, enter highest
score if taken more than once
e.g. 3.9 out of 4.0; 4.3 out of 4.5 etc.
Number of Years Actively
Participated *
Position held if any
(e.g. Editor, President, Secretary, etc.)
1.
2.
3.
* Active participation in an activity means devoting on an average at least two hours per week during the school year, or
equivalent total time (about 80 hours) during the year (e.g. summer activity/job etc.).
Other Awards, Honors, Recognition
1.
2.
3.
4.
5.
Local
State
Check the level
National
International
: Mrs. Rasila Bhalodia
44 Tremont Drive
East Hanover, NJ 07936
Entry Deadline : Must be post-marked no later than 15 days prior to the date of Diwali Function
Questions?
: Call Mrs. Rasila Bhalodia at (973) 428-0031; e-mail: bhalodia@apcontech.com
Mail Entry to
Do Not submit any other information or supporting documents with the entry form. All information required to evaluate
candidates on a consistent basis must be provided on this entry form under Honor system. Incomplete form will not be
considered. Winners will be notified within four weeks after the entry deadline, and may be asked to provide necessary
documents to validate their entry information.
Rev. 10/2012
President
Vice President
Secretary
Kiran Ghodasara
Manu Dadhania
Sanjay Jagani
Treasurer
Prakash Govani
(732) 761-9829
(856) 751-8117
(609) 897-0250
(215) 343-8586
LIFE TIME MEMBERSHIP REGISTRATION FORM
Life time family membership donation is $ 250.00
Please make check payable to ‘PCA of USA’ and Mail this form to:
Prakash Govani
2030 Ballantine Lane,
Warrington, PA 18976-2737
Please print all details in UPPER CASE
Family (Last) Name ________________________________________
First Name ____________________________________Middle Name_________________________________________
Father’s / Husband’s - Full Name ______________________________________________________________________
Street Address _________________________________City __________________________ State ____ ZIP __________
Phone - Home (______) ______-________ Cell (______) ______-________ Work (______) ______-________
Email address ______________________________________________________________________________
Original Home Town in India _________________________________________________________________
Wife’s Maiden Name (Wife’s Last Name before marriage) __________________________________________

If you use ‘PATEL’ as your official Family (Last) Name then check here: ________________________

List only Immediate Family Members in Order ( Include Yourself, Spouse, Unmarried Children, Unmarried
Brothers & Sisters, & Parent(s) living with you). You may copy this form to add more members
Name
Marital Status
Relationship Year of Birth Occupation
Email or Phone
By signing below, you agree to use of above information for our Association’s Directory Publication.
Your Signature _________________________ Date__________________
Print Name __________________________________________________
Please visit us at http://www.pcaofusa.org for e-mail signup & other information.
President
Vice President
Secretary
Kiran Ghodasara
Manu Dadhania
Sanjay Jagani
Treasurer
Prakash Govani
(732) 761-9829
(856) 751-8117
(609) 897-0250
(215) 343-8586
CHARITABLE DONATION FORM
Last Name ______________________ First Name ____________________ Middle_______________
Street Address ______________________________________________________________________
City ________________________________________________ State _________ ZIP _____________
Home Phone (______) ______ - ________
Work Phone (______) ______ - ________
Email Address ___________________________________________________________
Amount of Donation $ ___________________________ Check # __________________
Purpose of Donation ________________________________________________________
***If this is to be used In Memory of / To Honor, please describe***
Grand Sponsor
Dinner Sponsor
Raffle Prizes
Aarti Thaali Competition Prizes
Dessert Competition Prizes
Game Show Prizes
Karaoke Talent Show
Trophies
Our Community Hall
$ 5000
$ 4000
$ 500
$ 250
$ 250
$ 250
$ 200
$ 200
$
__________
__________
__________
__________
__________
__________
__________
__________
__________
TOTAL
$
__________
Please make Checks Payable to ‘PCA of USA’ Mail to:
Mr. Prakash Govani
2030, Ballantine Lane,
Warrington, PA 18976-2737
THANK YOU FOR YOUR SUPPORT!
***Matching Gift / Donation Contribution Program***
If your Company/Employer participates in matching gift or contribution program, please list
‘PCA of USA’ as matching receiving Organization. Please include following details:
Organization Address: PCA of USA, 32 Stevenson Drive, Marlboro, NJ 07746.
Phone : 732-761-9829. Non Profit Charitable 501 c (3) Tax ID # 22-3031050.
Please visit us at http://www.pcaofusa.org for e-mail signup & other information.